Name: Score:
313 Multiple choice questions
,Term 1 of 313
87.) A client with acute muscle spasms has been taking baclofen (Lioresal). The client calls the
clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about
discontinuing the medication. The nurse should make which appropriate response to the client?
1. "You should never stop the medication."
2. "It is best that you taper the dose if you intend to stop the medication."
3. "It is okay to stop the medication if you think that you can tolerate the muscle spasms."
4. "Weakness and fatigue commonly occur and will diminish with continued medication use."
4. Acetylsalicylic acid (aspirin)
Rationale:
Ticlopidine hydrochloride is a platelet aggregation inhibitor. It is used to decrease the risk
of thrombotic strokes in clients with precursor symptoms. Because it is an antiplatelet
agent, other medications that precipitate or aggravate bleeding should be avoided during
its use. Therefore, aspirin or any aspirin-containing product should be avoided.
4. "Weakness and fatigue commonly occur and will diminish with continued medication
use."
Rationale:
The client should be instructed that symptoms such as drowsiness, weakness, and fatigue
are more intense in the early phase of therapy and diminish with continued medication use.
The client should be instructed never to withdraw or stop the medication abruptly, because
abrupt withdrawal can cause visual hallucinations, paranoid ideation, and seizures. It is best
for the nurse to inform the client that these symptoms will subside and encourage the client
to continue the use of the medication.
2. Taking the medication with food will help to prevent the nausea.
Rationale:
If carbidopa/levodopa is causing nausea and vomiting, the nurse would tell the client that
taking the medication with food will prevent the nausea. Additionally, the client should be
instructed not to take the medication with a high-protein meal because the high-protein
will affect absorption. Antiemetics from the phenothiazine class should not be used
because they block the therapeutic action of dopamine.
*eliminate options 3 and 4 because they are comparable or alike*
2. Checking the frequency and consistency of bowel movements
Rationale:
The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab
(Remicade) is an immunomodulator that reduces the degree of inflammation in the colon,
thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
,Term 2 of 313
-azine
- setron
S/S: anticholenergic effects (cant see, spit, pee, poop), drowsiness
NI: use cautiously pts w/ HTN, PUD, urinary retention, assess hypokalemia, BP, Advise to
take @ night
Corticosteroid
prevent inflammatory response
S/S: Hyperglycemia, peptic ulcer, fluid retention (increased appetite), withdrawal
symptoms, euphoria, insomnia, psychotic behavior
NI: admin w/ meals, DO NOT take with NSAIDS, teach DO NOT stop abruptly
Common meds- prednisone (deltasone), betamethasone (celestone), hydrocortisone
sodium succinate (Solu-cortef), Methylprednisolone sodium succinate (solu-medrol),
fluticasone propionate (advair, flovent)
Periodic determination of serum electrolytes to detect possible electrolyte imbalance
should be done at appropriate intervals.
Antiemtic
reduce N & V
S/S: drowsiness, anticholenergic effects, restlessness, tardive dyskinesia, EPS
NI: monitor VS
Common meds- promethazine (phenergan), metaoclopramide (reglan), ondansertron
(zofran)
Term 3 of 313
Singulair
Bronchodilator
S/S: tachcardia, palpitations, tremors
Common meds- albeuterol
used before exercise to prevent breathing problems during exercise (bronchospasm).
same as-alendronate is used for treating osteoporosis in men and postmenopausal women.
used to treat or prevent certain urinary tract infections
, Term 4 of 313
74.) A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for
signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks
the medication supply to ensure that which medication is available for administration if a
cholinergic crisis occurs?
1. Vitamin K
2. Atropine sulfate
3. Protamine sulfate
4. Acetylcysteine (Mucomyst)
2. Refrigerate the insulin.
Rationale:
Insulin in unopened vials should be stored under refrigeration until needed. Vials should
not be frozen. When stored unopened under refrigeration, insulin can be used up to the
expiration date on the vial. Options 1, 3, and 4 are incorrect.
2. Gastrointestinal dysfunctions
Rationale:
The most common adverse effects related to fluoxetine include central nervous system
(CNS) and gastrointestinal (GI) system dysfunction. This medication affects the GI system by
causing nausea and vomiting, cramping, and diarrhea. Options 1, 3, and 4 are not adverse
effects of this medication.
4. A direct bilirubin level of 2 mg/dL
Rationale:
In adults, overdose of acetaminophen (Tylenol) causes liver damage. Option 4 is an
indicator of liver function and is the only option that indicates an abnormal laboratory
value. The normal direct bilirubin is 0 to 0.4 mg/dL. The normal platelet count is 150,000 to
400,000 cells/mm3. The normal prothrombin time is 10 to 13 seconds. The normal sodium
level is 135 to 145 mEq/L.
2. Atropine sulfate
Rationale:
The antidote for cholinergic crisis is atropine sulfate. Vitamin K is the antidote for warfarin
(Coumadin). Protamine sulfate is the antidote for heparin, and acetylcysteine (Mucomyst) is
the antidote for acetaminophen (Tylenol).
313 Multiple choice questions
,Term 1 of 313
87.) A client with acute muscle spasms has been taking baclofen (Lioresal). The client calls the
clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about
discontinuing the medication. The nurse should make which appropriate response to the client?
1. "You should never stop the medication."
2. "It is best that you taper the dose if you intend to stop the medication."
3. "It is okay to stop the medication if you think that you can tolerate the muscle spasms."
4. "Weakness and fatigue commonly occur and will diminish with continued medication use."
4. Acetylsalicylic acid (aspirin)
Rationale:
Ticlopidine hydrochloride is a platelet aggregation inhibitor. It is used to decrease the risk
of thrombotic strokes in clients with precursor symptoms. Because it is an antiplatelet
agent, other medications that precipitate or aggravate bleeding should be avoided during
its use. Therefore, aspirin or any aspirin-containing product should be avoided.
4. "Weakness and fatigue commonly occur and will diminish with continued medication
use."
Rationale:
The client should be instructed that symptoms such as drowsiness, weakness, and fatigue
are more intense in the early phase of therapy and diminish with continued medication use.
The client should be instructed never to withdraw or stop the medication abruptly, because
abrupt withdrawal can cause visual hallucinations, paranoid ideation, and seizures. It is best
for the nurse to inform the client that these symptoms will subside and encourage the client
to continue the use of the medication.
2. Taking the medication with food will help to prevent the nausea.
Rationale:
If carbidopa/levodopa is causing nausea and vomiting, the nurse would tell the client that
taking the medication with food will prevent the nausea. Additionally, the client should be
instructed not to take the medication with a high-protein meal because the high-protein
will affect absorption. Antiemetics from the phenothiazine class should not be used
because they block the therapeutic action of dopamine.
*eliminate options 3 and 4 because they are comparable or alike*
2. Checking the frequency and consistency of bowel movements
Rationale:
The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab
(Remicade) is an immunomodulator that reduces the degree of inflammation in the colon,
thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
,Term 2 of 313
-azine
- setron
S/S: anticholenergic effects (cant see, spit, pee, poop), drowsiness
NI: use cautiously pts w/ HTN, PUD, urinary retention, assess hypokalemia, BP, Advise to
take @ night
Corticosteroid
prevent inflammatory response
S/S: Hyperglycemia, peptic ulcer, fluid retention (increased appetite), withdrawal
symptoms, euphoria, insomnia, psychotic behavior
NI: admin w/ meals, DO NOT take with NSAIDS, teach DO NOT stop abruptly
Common meds- prednisone (deltasone), betamethasone (celestone), hydrocortisone
sodium succinate (Solu-cortef), Methylprednisolone sodium succinate (solu-medrol),
fluticasone propionate (advair, flovent)
Periodic determination of serum electrolytes to detect possible electrolyte imbalance
should be done at appropriate intervals.
Antiemtic
reduce N & V
S/S: drowsiness, anticholenergic effects, restlessness, tardive dyskinesia, EPS
NI: monitor VS
Common meds- promethazine (phenergan), metaoclopramide (reglan), ondansertron
(zofran)
Term 3 of 313
Singulair
Bronchodilator
S/S: tachcardia, palpitations, tremors
Common meds- albeuterol
used before exercise to prevent breathing problems during exercise (bronchospasm).
same as-alendronate is used for treating osteoporosis in men and postmenopausal women.
used to treat or prevent certain urinary tract infections
, Term 4 of 313
74.) A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for
signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks
the medication supply to ensure that which medication is available for administration if a
cholinergic crisis occurs?
1. Vitamin K
2. Atropine sulfate
3. Protamine sulfate
4. Acetylcysteine (Mucomyst)
2. Refrigerate the insulin.
Rationale:
Insulin in unopened vials should be stored under refrigeration until needed. Vials should
not be frozen. When stored unopened under refrigeration, insulin can be used up to the
expiration date on the vial. Options 1, 3, and 4 are incorrect.
2. Gastrointestinal dysfunctions
Rationale:
The most common adverse effects related to fluoxetine include central nervous system
(CNS) and gastrointestinal (GI) system dysfunction. This medication affects the GI system by
causing nausea and vomiting, cramping, and diarrhea. Options 1, 3, and 4 are not adverse
effects of this medication.
4. A direct bilirubin level of 2 mg/dL
Rationale:
In adults, overdose of acetaminophen (Tylenol) causes liver damage. Option 4 is an
indicator of liver function and is the only option that indicates an abnormal laboratory
value. The normal direct bilirubin is 0 to 0.4 mg/dL. The normal platelet count is 150,000 to
400,000 cells/mm3. The normal prothrombin time is 10 to 13 seconds. The normal sodium
level is 135 to 145 mEq/L.
2. Atropine sulfate
Rationale:
The antidote for cholinergic crisis is atropine sulfate. Vitamin K is the antidote for warfarin
(Coumadin). Protamine sulfate is the antidote for heparin, and acetylcysteine (Mucomyst) is
the antidote for acetaminophen (Tylenol).
